干燥综合征腮腺早期损伤的功能磁共振成像研究

发布时间：2018-06-04 13:47

  本文选题：T1ρ + MR成像　； 参考：《南京大学》2017年硕士论文

【摘要】：第一部分Tiρ磁共振成像对干燥综合征的早期诊断研究目的:探测旋转框架内自旋晶格弛豫时间(T1ρ)MR成像对干燥综合征(Sjogren's syndrome,SS)早期诊断的价值。方法:对32名腮腺无形态学改变的SS患者和32名性别、年龄匹配的健康志愿者行3.0TMR检查,包括Tiρ序列。3个月后采用相同序列重复扫描。配对t检验比较双侧腺体T1信号和Tiρ值。独立样本t检验比较志愿者与SS患者T1信号和Tiρ值。使用ROC曲线评估Tiρ值的诊断价值。组内相关系数(ICC)评估腮腺Tiρ测量的可重复性。结果:SS患者和健康志愿者的双侧腺体T1信号和Tiρ值无差异性(P分别为0.170,0.886,0.942和0.229)。SS患者与健康志愿者的T1值无差异性(P = 0.655)。SS患者的Tiρ值(96.47± 15.38 ms)显著高于健康志愿者(84.25 ± 6.11 ms,P0.001)。Tiρ值诊断SS的阈值为88.02 ms,诊断的灵敏度和特异度分别为75.0%和100.0%。Tiρ测量的可重复性优(ICC:0.934～0.995)。结论:Tiρ MR成像可以有效诊断腮腺腺体无形态学改变的SS患者。第二部分 体素内不相干运动成像在干燥综合征腮腺损伤分级中的应用目的:探索体素内不相干运动(Intravoxel incoherent motion,IVIM)磁共振(Magnetic resonance,MR)成像参数和干燥综合征(Sjogren's syndrome,SS)患者腮腺腺体MR结节分级的相关性。方法:31位确诊的SS患者和28名性别、年龄匹配的健康志愿者行3.0T MR腮腺检查。IVIM检查序列包括9 b值,范围为0～800 s/mm2。双侧腺体的表观扩散系数ADC,扩散系数D,伪扩散系数D*和灌注分数f,并根据MR形态学表现对腮腺实质进行结节分级。结果:31位SS患者共62个腺体,MR结节分级为0,1,2,3级的分别有32,14,8和8个腺体。腺体分级为0,1,2和3级以及志愿者的ADC值分别为(1.13± 0.25,1.11 ± 0.17,1.05 ± 0.24,0.89 ± 0.04,1.00 ± 0.21)×10-3mm-2/s,D 值分别为(0.92 ± 0.13,0.90 ± 0.19,0.90 ± 0.03,0.67 ± 0.03,0.81 ± 0.03)×10-3Omm2/s,f 值分别为 0.20 ± 0.04,0.18 ± 0.02,0.15 ± 0.01,0.11 ± 0.01,0.15 ± 0.06,和 D*值分别为(53.89 ± 28.26,41.78 ± 16.35,51.24 ± 18.69,31.83 ± 18.03,36.83 ± 16.14)x10-3 mm2/s。0级SS患者腺体的ADC,D,f和D*值均显著高于健康志愿者(P值均0.05)。SS患者级别间D和f值具有显著统计学差异(P值分别为0.003,0.001)。在早期(分级0～1级)SS患者的D和f值显著高于健康志愿者,而进展期(分级2～3级)SS患者的D和f值显著低于健康志愿者(P值均0.05)。参数D和f值与MR结节分级呈显著正相关(系数分别为r =-0.297,P = 0.019;r =-0.653,P0.001)。结论:腮腺不同MR结节分级的SS患者,反映了腺体在不同时期具有不同的病理生理特征。
[Abstract]:Part I: early diagnosis of Sjogren's Syndrome with Ti 蟻 Magnetic Resonance objective: to investigate the value of detecting spin lattice relaxation time and T 1 蟻 Mr imaging in the early diagnosis of Sjogren's syndrome (SS). Methods: 3.0TMR was performed in 32 SS patients with no morphologic changes of parotid gland and 32 healthy volunteers with gender and age matching, including Ti 蟻 sequence, and repeated scanning with the same sequence 3 months later. The T 1 signal intensity and Ti 蟻 value of bilateral glands were compared by paired t test. T-test was used to compare T 1 signal intensity and Ti 蟻 value between volunteers and SS patients. The diagnostic value of Ti 蟻 value was evaluated by ROC curve. The reproducibility of Ti 蟻 measurement in parotid gland was evaluated by ICC- (intra-group correlation coefficient). Results there was no difference in T1 signal intensity and Ti 蟻 value of bilateral glands between the two groups (P = 96.47 卤15.38 Ms, P = 96.47 卤15.38 Ms), P = 96.47 卤15.38 Ms, P = 96.47 卤15.38 Ms, P = 96.47 卤15.38 Ms, P = P = 96.47 卤15.38 Ms, P = 96.47 卤15.38 Ms, P = P = 96.47 卤15.38 Ms, P = P = 96.47 卤15.38 Ms, respectively. The diagnostic threshold of SS was 88.02 Ms, the diagnostic sensitivity and specificity were 75.0% and the repeatability of 100.0%.Ti 蟻 was better than that of ICC: 0.934 / 0.995ms. Conclusion: t Ti 蟻 Mr imaging can effectively diagnose SS patients with no morphologic changes of parotid gland. Application of voxel incoherent motion imaging in the classification of parotid gland injury in Sjogren's syndrome objective: to explore the imaging parameters of intra voxel incoherent motif and Sjogren's syndromesia in patients with Sjogren's syndrome. Correlation of Mr nodule grading. Methods Thirty one confirmed SS patients and 28 age matched healthy volunteers underwent 3.0T Mr parotid gland examination. IVIM sequence consisted of 9 b values in the range of 0 ~ 800 s / mm ~ (2). The apparent diffusion coefficient (ADCD), diffusion coefficient (D), pseudo-diffusion coefficient (D *) and perfusion fraction (f) of bilateral glands were classified according to the morphologic features of parotid gland. Results in 31 patients with SS, there were 32 cases with Mr grade 0 1 and 2 grade 3 with 8 glands. The ADC values of the patients with 0 ~ 1g ~ (-2) and 3 ~ (th) glandular grade were 1.13 卤0.251.11 卤0.171.05 卤0.24 卤0.24 卤1.00 卤0.21) 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1) D = 0.92 卤0.130.90 卤0.190.90 卤0.03 卤0.67 卤0.03 卤0.81 卤0.03) 脳 10 ~ (-3) Omm _ 2 / sf = 0.20 卤0.04 卤0.18 卤0.020.15 卤0.011 卤0.01 卤0.15 卤0.06, respectively, and the D * values were 0.53 卤0.089 卤0.89 卤0.06, respectively, and the values of D * were 0.20 卤0.04 卤0.18 卤0.020.15 卤0.021 卤0.15 卤0.06 卤0.06 and 0.93 卤0.130.90 卤0.190.90 卤0.03 卤0.81 卤0.03 卤0.81 卤0.03, respectively. The ADF and D * values of the glands in the patients with SS were significantly higher than those in the healthy volunteers (P = 0.0030.001, P = 0.003, P = 0.003, P = 0.003, P = 0.003, P = 0.003, P = 0. 001, P = 0. 0030. 001P, P = 0. 0030. 001respectively). The values of D and D * in the glands of the patients with SS were significantly higher than those of the healthy volunteers (P = 0. 0030. 001). In the early stage (grade 0 ~ 1), the D and f values of SS patients were significantly higher than those of healthy volunteers, while the D and f values of patients with advanced stage SS were significantly lower than those of healthy volunteers (P = 0.05). The parameters D and f were positively correlated with Mr nodule grading (r = 0.297, P = 0.019 ~ 0.653U, P = 0.001, respectively). Conclusion: SS patients with different Mr nodule grades in parotid gland reflect different pathophysiological characteristics of glands at different stages.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R593.2
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